ABSTRACT
Health care providers are facing increased risk of moral distress during the COVID-19 pandemic because of changes in clinical practice and resource allocation procedures. Health care systems that employ a proactive approach in mitigating the lasting effects of moral distress will fare better in the long run. Psychologists are well poised to apply timely psychological first aid to the crisis needs of patients, colleagues, and even themselves. Key interventions are detailed, including creating and promoting safety, calmness, connectedness, self-efficacy, and hope.
ABSTRACT
A description of the effects of delirium on attention is provided. Nursing implications pertinent to appropriate assessment for attention deficits, interventions to maintain patient safety, and discharge planning for the older adult with persistent delirium are also discussed.
Subject(s)
Delirium/nursing , Geriatric Assessment/methods , Nursing Assessment/methods , Patient Discharge , Aged , Aged, 80 and over , Delirium/diagnosis , Female , Humans , Needs Assessment/organization & administration , Nurse's Role , Patient Care Planning , Risk Assessment/methods , Safety ManagementABSTRACT
Although commonly addressed in magazines, across airwaves, and within gyms nationwide, health care providers must now face the growing epidemic of obesity in their daily practice. With the graying of America, it is all the more important to realize that weight increases the risk for disease and mortality in the elderly. Despite overwhelming evidence that weight loss can reduce health risks, many patients who are overweight never receive needed advice from their primary care physicians. This article addresses the barriers to physician intervention, methods to assess obesity risk, and readiness to change. Effective approaches for assisting in successful weight loss and maintenance are discussed.
Subject(s)
Obesity/therapy , Weight Loss , Aged , Humans , Primary Health CareABSTRACT
Regulation of nuclear receptor activity is the focus of numerous ongoing studies to develop novel therapies for the treatment of hormone-related cancer. Although cyclin D1 functions to control the activity of several nuclear receptors, the region(s) of the protein responsible for such transcriptional comodulation remain poorly defined. Herein, we map the region of cyclin D1 required for binding and repression of the androgen receptor (AR) to a central, exclusively alpha-helical domain. Deletion of this domain disrupted AR binding and corepressor activity. Further investigations showed that this domain is sufficient for AR interaction and possesses the ability to bind histone deacetylase 3. Strikingly, overexpression of this repressor region attenuates cell cycle progression in prostatic adenocarcinoma cells. The requirement of this domain for nuclear receptor repression was conserved with respect to thyroid hormone receptor beta-1, whereas cyclin D1 activation of the estrogen receptor occurred independently of the central region. Together, these data identify a minimal repression module within cyclin D1 and demonstrate that the coactivator and corepressor functions of cyclin D1 are distinct. In addition, our data suggest that properties of the cyclin D1 central domain could be exploited to develop novel prostate cancer therapeutics.
